Pneumococcus: how is it transmitted & how does the vaccine protect us?

How is pneumococcus spread?
The transmission of the microbe from person to person is through droplets produced during coughing, sneezing and close contact, either by sick or healthy individuals who are carriers. The infection can be seen throughout the year, but is more common in winter and early spring.

Before the introduction of pneumococcal vaccination, pneumococcus was the most common cause of bacterial pneumonia. However, pneumococcal infection can also manifest as otitis, sinusitis, meningitis and bacteremia. It most commonly affects young children, the elderly and people with underlying diseases, but young and healthy people can also be affected. The onset of the disease is often sudden, especially in patients without a functioning spleen, and is accompanied by high mortality, especially in the above risk groups.

Pneumococcal vaccine
Our best defense in the case of pneumococcal infection is prevention. The widespread use of the pneumococcal vaccine in children has resulted in a reduction in the incidence and mortality of pneumococcal pneumonia in both children and adults.

That is, by initially vaccinating infants and children, the total germ load was reduced in the entire population and a significant reduction in pneumonia cases was observed in both children and adults. This observation led to the vaccination of adults to further reduce the incidence of pneumococcal infection.

There are two types of pneumococcal vaccine available:

1. The 13-potency protein conjugate vaccine (PCV13)
The pneumococcal conjugate vaccine is given to infants from the age of two months and three or four booster doses are required depending on the age at which vaccination is started. Adults only need one dose. Vaccination produces long-lasting immunity against the 13 most aggressive pneumococcal serotypes.

According to the National Immunization Program, the vaccine should be given to infants, children and adults over 65 years of age, as well as to people of any age group who have underlying conditions that predispose them to invasive pneumococcal disease (patients with chronic respiratory diseases, malignancies etc.). Conjugated pneumococcal vaccine can be given at the same time as trivalent inactivated influenza vaccine.

2. The 23-potency polysaccharide vaccine (PPSV-23)
It is only given to adults and is indicated for all people over 65 years of age. Vaccination of persons under 65 years of age is recommended when there are respiratory diseases (bronchial asthma, COPD, emphysema), diabetes mellitus, cardiovascular diseases, immunosuppression, functional or anatomical asplenia, HIV infection, cirrhosis, chronic renal failure, nephrotic syndrome, cerebrospinal shunt, when patients have cochlear implants or reside in long-term care facilities.

For people aged 19-64, a revaccination is recommended once every 5 years after the initial vaccination. In persons >65 years of age, revaccination is recommended, once, if they were vaccinated at least 5 years ago and were then 65 years old. Patients undergoing planned splenectomy should be vaccinated at least 2 weeks prior to surgery.

Time of administration of the 2 vaccines
In patients who have not received either vaccine and there is an indication for their administration, the conjugate vaccine (PCV13) is initially administered. The conjugate vaccine (PCV13) is given only once to adults. Polysaccharide vaccine (PPSV23) should follow at least 2 months later.

In case the polysaccharide vaccine (PPSV23) has preceded, the conjugate should follow at least 1 year later.

She writes:
Eleni Patrozou
Pathologist – Infectious
Scientific Associate HYGEIA

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